Cholera Outbreak – Why Now?

One question we have continually asked ourselves during this week is –Why now? Doesn’t it seem likely that with Haiti’s lack of plumbing, lack of water, and lack of widespread medical care, an outbreak would have already occurred? WWR has been situated in Mirebalais for more than a year facing these exact concerns. As a team, we found out about the crisis through text messages. While the recent sounds of UN helicopters, the out-the-door lines at hospitals, and the recent rise in water prices give a general unease to city life in Mirebalais, things are largely the same. What we can do is to continue to educate the students about the pittance of potable water. We were making progress before the cholera outbreak and we will make progress after. The cholera might leave, but we won’t.

As a cultural reference point, Jean Baptiste, Haitian Program Director asked 8-9 year old students the role of germs in their community. A young girl quickly replied, “Mikwob pa touye Hatienne” (Germs don’t kill Haitians). A clear reminder for why educating children is the solution.

WWR’s most recent phase in Mirebalais has been infused with energy by Moisel Bapiste, a Haitian-American PhD from Ithaca College. After joining an immediate response force in January, Mo returned to Haiti for WWR’s educational element of the WASH in schools program. On October 17th, starting the WASH program proved a challenge, as the crew seeks to educate over 4,000 students in 3 schools. Despite the lack of any organized school administration, the team pressed on with education—using posters, educational games, and hand washing songs. Crucial to the WASH movement is the team’s ability to relate to Haitian children with educational materials written in Creole. As much material is produced in French, or English, the team’s capacity to educate in the students’ native language is proving vital. As the team begins their work within the classroom, Haiti faces another crisis outside of the classroom—a cholera outbreak. Thus, the team responded by adding extra lessons, and student hand washing training. Specifically targeting students and reminding them to wash their hands after using toilettes, washing their hands before eating or drinking, and to relate to students how germs spread. The team also executed a comprehensive baseline survey that will help to understand how students relate to health and hygiene issues at school and within their homes. Eske-w lave men-w avek savon apre-w soti la toilette la? Did you wash your hands with soap after you used the toilette? During the commute back home team member Kenny Etienne muttered to himself, “By now, life is too hard.” Tomorrow, the team will again walk to the 3 schools with their open air classrooms casually packed with 75 students. No electricity. 90 degree humidity. Nou pa kampe. We can’t stop.

Aside from the school setting, we have noticed solidified actions against the current outbreak. Zanmi Asante, the Partners in Health programming in Haiti, has delivered public service announcements through mobile loudspeakers. The announcements seek to reiterate how important it is to wash your hands before breast feeding, cover food that is left out, and to ensure that containers used for collecting clean water are in fact clean themselves. One of the strongest communal actions has been the community’s awareness of river water contamination. Artibonite, the Carribean’s largest river, is believed to have been an initial carrier of the cholera outbreak. This knowledge has spread by word of mouth. As we take our evening walks down by the river, we are constantly reminded that, Ou pa bezwen benyen nan l’artibonite. You shouldn’t bathe in the river. In a country where rumor turns to facts, and facts are hard to come by, this general rule has been validated by the community’s refusal to use the river for bathing, for washing clothes, or for a refreshing swim after school. Indeed, it feels very foreign to walk along the river without actually getting in. As if the river itself is lonely, void of splashing teens, void of vibrantly colored clothes, and void of women soaping down their children. All is quiet there.